[Underreporting of maternal deaths in Paraná State, Brazil: 1991-2005].
The objective of this article was to analyze the underreporting of maternal deaths in Paraná State, Brazil, from 1991 to 2005, identifying details on the basic causes that keep maternal deaths hidden and problems with completing items 43 and 44 on death certificates during a recent period (2003-2005). Data were obtained from the database of the Paraná State Committees for the Prevention of Maternal Mortality, which investigate maternal deaths using the Reproductive Age Mortality Survey (RAMOS). According to the data, maternal mortality decreased by 26% in 15 years, but the level of underreporting remained the same, generating adjustment factors ranging from 1.6 to 1.8. In conclusion, medical schools and the State medical board should provide more incisive and comprehensive orientation on completing death certificates in order to minimize this underreporting. The Paraná State Committees for the Prevention of Maternal Mortality help correct underreporting of maternal deaths by identifying their real causes and determinants and defining strategies to reduce them. More effective measures to reduce avoidable maternal deaths are still needed in the State.
Soares
Vânia Muniz Néquer
VM
Secretaria de Estado da Saúde do Paraná, Curitiba, Brasil. vaniam@onda.com.br
de Azevedo
Elbens M Minorelli
EM
Watanabe
Terezinha L
TL
D001723:Birth Rate; D001938:Brazil / Q000453:epidemiology; D002423:Cause of Death; D003625:Data Collection / Q000379:methods* / Q000592:standards; D003644:Death Certificates; D005260:Female; D006801:Humans; D007256:Information Systems / Q000592:standards / Q000706:statistics & numerical data*; D008427:Maternal Health Services / Q000592:standards; D008428:Maternal Mortality; D008499:Medical Records; D011314:Preventive Health Services